• 치과방사선
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• 제18권1호
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• pp.167-176
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• 1988

This study was designed to evaluate the morphology of the temporomandibular joint components and dentofacial characteristics of patients with clicking and painful temporomadibular joint. The materials consisted of 80 conventional pantomographs in normal an symptomatic individuals aged 18-23 and divided into 2 groups by symptom of temporomandibular joint. The results were as follows; 1. In morphologic analysis of condylar head, type Ⅰ (anterior, posterior smooth curve) was most dominant in both group(58.75%, 55.0%) and asymmetrical condylar shape was predominant in symptomatic group (18 cases, 45%). 2. In symptomatic group, the condylar width were slightly lesser and the ratio of condylar height to height of condyle-ramus were larger than those of normal group. 3. Vertical overlap of central incisor of symptomatic group was slightly larger than that of normal group. There was significant differences between each group in mandibular midline deviation. 4. The symptomatic group tended to steep mandibular plane angle and the degree of condylar path and condylar axis of normal group were larger than those of symptomatic group. 5. The condylar width was inversely correlated with inclination of condylar path and inclination of condylar path was correlated with condylar axis in both groups.

• 대한치과교정학회지
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• 제45권2호
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• pp.95-101
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• 2015

The aim of this case report is to describe the treatment of a patient with skeletal Class III malocclusion with maxillary retrognathia using skeletal anchorage devices and intermaxillary elastics. Miniplates were inserted between the mandibular lateral incisor and canine teeth on both sides in a male patient aged 14 years 5 months. Self-drilling mini-implants (1.6 mm diameter, 10 mm length) were installed between the maxillary second premolar and molar teeth, and Class III elastics were used between the miniplates and miniscrews. On treatment completion, an increase in the projection of the maxilla relative to the cranial base (2.7 mm) and significant improvement of the facial profile were observed. Slight maxillary counterclockwise ($1^{\circ}$) and mandibular clockwise ($3.3^{\circ}$) rotations were also observed. Maxillary protraction with skeletal anchorage and intermaxillary elastics was effective in correcting a case of Skeletal Class III malocclusion without dentoalveolar side effects.

• 대한두개안면성형외과학회지
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• 제21권6호
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• pp.384-386
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• 2020

This report describes osteotomy and iliac bone graft for malunion caused by failed mandibular fracture reduction. A 27-year-old man was referred 3 months after a motor vehicle accident. At another hospital, two operations had been performed for symphyseal fracture using two resorbable plates. Malocclusion was noted, and panoramic radiography and computed tomography revealed a misaligned dental arch, with a 9.37-mm gap between the central and the lateral incisor of the left mandible. A wafer was made from the patient's dental model, and a maxillary arch bar was applied. Through a lower gingivolabial incision, osteotomy was performed between the malunited symphyseal fracture segments. Both segments were reduced to their original position using the wafer and fixed with titanium miniplates via intermaxillary fixation (IMF). The intersegmental gap was filled with cancellous bone from the iliac crest. The gingival defect was covered with a mucosal transposition flap from the gingivolabial sulcus. IMF and the wafer were maintained for 5 and 9 weeks, respectively. At postoperative week 13, the screws were removed from the mandible and satisfactory occlusion was noted. His mouth opening improved from 2.5 to 3 finger breadths (40 mm). This case demonstrates the need for sufficient IMF when using resorbable plates.

• 대한치과교정학회지
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• 제9권1호
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• pp.85-98
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• 1979

This investigation was designed to compare the craniofacial and dental morphology of class III malocclusion with that of normal occlusin in children, and to determine the incidence of various class III craniofacial skeletal patterns. The material selected for this study consisted in standard lateral cephalograms of eighty two Korean children, forty one boys and forty one girls, aged 10 through 12 years, having class III malocclusion, and forty two Korean children, twenty boys and twenty two girls, with normal occlusion in the same age. Using the tracings of the standard lateral cephalograms, various angular and linear measurements were recorded, tabulated and statistically analyzed, and then the class III craniofacial skeletal morphology was divided into various patterns by the degree of SNA and SNB, which respectively were below, within or beyond the normal range of those of normal occlusion. The following characteristics of the craniofacial and dental morphology of class III malocclusion were observed. 1. The cranial base length of class III malocclusion was smaller than that of normal occlusion, and the small saddle angle was a characteristic figure of class III malocclucion. 2. Maxillary length of class III malocclusion was smaller than that of normal occlusion, and point A was retropositioned relative to cranial base but not PNS in class III malocclusion. Maxillary base inclination was not significantly different between the two, but occlusal plane to palatal plane was small in class III malocciusion. 3. The mandibular body length shown no difference between the two, but the mandibular body positioned anteriorly relative to cranial base in class III malocclusion. Ramus height, gonial angle, and mandibular effective length were large in class III malocclusion. Mandibular plane angle and joint angle had no difference between the two, and occlusal plane to mandibular plane angle was large in class III malocclusion. 4. Maxillary incisor inclination was not significantly different between class III malocclusion and normal occlusion, but mandibular incisors positioned and inclined lingually and consequently interincisal angle was large in class III malocclusion. 5. Class III malocclusion was divided into six categories of craniofacial skeletal pattern. The most common class III pattern was found to be one in which the maxilla was within the normal range of prognathism while the mandible extended beyond this range. The pattern in which the maxilla was below the normal range of prognathism while the mandible was within this range was approximately one fifth of the class III sample.

• 대한치과보철학회지
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• 제31권3호
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• pp.394-410
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• 1993

This study was accomplished for appreciation of the mandibular moments according to antero- posterior movement of pivot placed on the lower natural dentition. For this study, 20 subjects(male, $21\sim30$ yrs., average age 24) in the category of normal occlusion were selected, and the intraoral Vitallium clutches were cast and fabricated for each subjects. A 2-dimension PSD(Position Sensitive Detector, Hamamatsu Photonics Co., Japan) was attached to maxillary clutch in a mode of three dimensional control and LED (Light Emit Diode, Hamamatsu Photonics Co., Japan) was set up on mandibular clutch. Both clutches were set into oral cavity of each subjects and adjusted. Then the subjects were allowed to intercuspated with maximal bite force while the pivoting ball in the mid-line moving from anterior toward posterior position. The displacement scales were recorded by CCD camera(Sony, CCD-TR-705) and VCR, The conclusions were as follows : 1. When the subject was allowed to bite the metal pivoting ball in the midline of lower dentition with maximal bite force voluntarily while moving from lower central incisor to canine, 1st premolar, End premolar, 1st molar and 2nd molar. The lever actions on the pivot were revealed in all subjects. The equilibrium of moment were revealed on the pivots of 1st premolar(14 subjects), End premolar(4 subjects), and canine(2 subjects) areas. 2. The changes of loading on the TMJ according to antero-posterior positional changes of metal pivoting ball were able to recognize as follow. Compression on the TMJ was increased when the pivot moves anteriorly from the equilibrium point, and tension on the TMJ was increased when posteriorly. 3. 13 subjects were recognized their habitual chewing sides(Rights, Left8), and 7 subjects were not. During maximal biting, mandible was displaced toward their habitual chewing sides on the metal pivoting ball in the frontal plane. 4. In cephalometric analysis, the average genial angle of 20 subjects was $116.75^{\circ}$ and the average mandibular body length was 79.77mm. The equilibrium points of mandibular moment were positioned more posteriorly in the subjects having larger Genial angle than in the smaller(p<0.05). Relationships among the angle between FH plane and occlusal plane, the angle between occlusal plane and mandibular plane , and mandibular body length were not significant(p>0.05).

• 대한치과교정학회지
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• 제42권5호
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• pp.227-234
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• 2012

Objective: To evaluate the presurgical orthodontic tooth movement of mandibular teeth after dental decompensation for skeletal Class III deformities on the basis of vertical skeletal patterns. Methods: This cohort was comprised of 62 patients who received presurgical orthodontic treatment. These patients were divided into 3 groups according to their vertical skeletal patterns. Changes in the positions of the mandibular central incisor, canine, premolar, and 1st molar after presurgical orthodontic treatment were measured using a cone-beam computed tomography (CBCT) superimposition method. Results: The incisors moved forward after dental decompensation in all 3 groups. The canines in group I and the 1st premolars in groups I and III also moved forward. The incisors and canines were extruded in groups I and II. The 1st and 2nd premolars were also extruded in all groups. Vertical changes in the 1st premolars differed significantly between the groups. We also observed lateral movement of the canines in group III and of the 1st premolar, 2nd premolar, and 1st molar in all 3 groups (p < 0.05). Conclusions: Movement of the mandibular incisors and premolars resolved the dental compensation. The skeletal facial pattern did not affect the dental decompensation, except in the case of vertical changes of the 1st premolars.

• 대한소아치과학회지
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• 제33권3호
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• pp.529-533
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• 2006

과잉치란 정상적인 치식과 비교했을 때 정상에 비하여 많은 수의 치아를 일컫는 것으로 유치열에 비하여 영구치열에서 더 흔하게 나타난다. 과잉치는 상악과 하악 모두에서 발생이 되지만 주로 상악에서 발생한다. 상악에서도 90% 가량이 상악의 전방부에서 발생하며, 일반적으로 알려진 과잉치의 발생 부위에 따른 빈도는 상악 중절치 및 상악 정중부, 상악 측절치, 하악 소구치, 상악 소구치, 상악 견치, 하악 견치, 하악 중절치의 순서를 따른다. 본 증례보고에서는 상악 소구치 과잉치와 하악 절치 과잉치의 흔치 않은 두 증례에 대해 보고한다. 첫 번째 증례에서는 하악 우측 측절치와 하악 우측 제1소구치 사이에 위치한 과잉치로 인하여 하악 우측 견치의 순측 맹출 양상 및 총생의 양상을 보였으며 두 번째 증례에서는 상악 좌측 제 1소구치와 제2소구치 사이에 위치한 과잉치로 인하여 상악 좌측 제2유구치의 치근 흡수와 제2소구치 치배의 비정상적인 위치를 보였다. 두 증례 모두 해당 과잉치의 발거를 시행하였으며 양호한 치료 결과를 얻었기에 보고하는 바이다.

• 대한치과교정학회지
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• 제26권5호
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• pp.637-645
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• 1996

성장이 완료된 골격성 III급 부정교합의 치료는 골격 부조화의 심도, 절치 치축, overbite와 연조직 측모의 심미성 등을 고려하여 필요한 경우 교정치료와 악교정수술을 병행하여 골격과 치아관계 개선에 따른 기능의 증진외에도 안모의 심미성을 증진시킬 수 있다. 특히 전후방적, 수직적, 횡적인 골격 부조화가 크거나 안면비대칭이 있는 경우, 또한 악교정수술후의 안정성이나 보다 이상적인 안모를 위하여 양악수술을 시행한다. 중안면부 함몰환자에서 안와하연과 관골부는 보존하며 비상악체를 전방이동하는 pyramidal Le Fort II osteotomy 를 시행할 수 있으며, 안와하연과 관골부치 전방이동을 필요로 할 때는 quadrangular Le Fort II osteotomy 를 시행할 수 있다. 이 수술법은 안와하연의 위치를 변화시켜 안와체적에 영향을 미치므로 상악골의 횡적, 수직적 이동량이 5 mm 이상일 때는 시행할 수 없다. 서울대학교병원 치과진료부 교정과에 내원하여 중안면부 함몰과 하악전돌을 동반한 골격성 III급 부정교합으로 진단되어 교정-악교정수술 (Le Fort II osteotomy 와 BSSRO) 복합치료를 받은 2명의 환자에 대해 살펴보고자 한다.

• 대한치과의사협회지
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• 제55권6호
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• pp.400-410
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• 2017

Approximately 30% of adult patients who want orthodontic treatment have transverse discrepancy with insufficient width of the maxilla. Particularly, in Class III patients requiring orthognathic surgery, the frequency of insufficient width of the maxillary arch related to respiratory problems is high. We report a case of non-surgical maxillary expansion using a Hyrax type expander with an orthognathic surgery, based on the reports that the ratio of non-fused midpalatal suture is not high in adults. A 30 years and 2 months old woman with a long face showed an Angle Class III with a vertical growth pattern. Class III molar and canine relation, anterior edge bite, and mandibular incisor compensatory lingual inclination were observed. The posterior buccal overjet seemed to be appropriate, but I diagnosed that there was a transverse discrepancy, for the following reasons. The inter-canine and inter-molar widths were sufficient but excessive lingual inclination of the mandibular molars was observed when assessing the bucco-lingual inclination based on the center of resistance of the maxillary and mandibular first molar. For this reason, it was expected that intercuspal interference would occur during orthodontic decompensation. Therefore, slow maxillary expansion using Hyrax type expander was performed and 2-jaw rotation surgery was performed to improve aesthetic and occlusion. Adults can also improve width discrepancy by non-surgical methods, which can avoid SARPE requiring additional surgery or segmental surgery lacking stability and predictability.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제21권1호
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• pp.35-40
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• 1999

Recently, sagittal split ramus oseotomy and intraoral vertical ramus osteotomy have been commonly performed for the correction of mandibular prognathism, occurred to abundant oriental people. Many authors have studied the soft tissue change after orthognathic surgery, especially between mandibular hard tissues and soft tissue of lower lip, but the study of upper lip change is comparatively little. Therefore, we studied the 12 patients, operated only sagittal split ramus osteotomy without genioplasty or maxillary osteotomy in department of oral and maxillofacial surgery, Hanyang university hospital from 1996. 1. 1. to 1998. 7. 20. Preoperative and postoperative cephalometric view was measured to know the change of upper lip position and shape after mandibular setback. The result were obtained as follows. 1. The ratio of upper lip change amount to lower incisor horizontal movement was 15.1%. 2. The ratio of lower facial profile between Sn-Stm and Stm-Mes was changed from 1 : 2.352 to 1 : 2.069 after operation. 3. Post-operative upper lip was flattened 72.4% compared with pre-operative one. 4. The vermilion zone of the upper lip increased 56 % horizontally, 5.8% vertically after operation. 5. The vermilion zone ratio of the lower lip to the upper lip was changed from 1 : 1.253 to 1 : 1.348. 6. The distance between esthetic line and Ls was changed from -3.958mm to -1.15mm.